Clinical Case Study: Abdominal Pain Evaluation

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Questions and Answers

Which of the following conditions is most likely to be associated with unintentional weight loss due to malignancy?

  • Lymphoma (correct)
  • Celiac disease
  • Diabetes
  • Peptic ulcer disease

What psychiatric condition listed is commonly linked to unintentional weight loss?

  • Bipolar disorder
  • Anxiety disorders
  • Depression (correct)
  • Schizophrenia

Which endocrine abnormality is associated with weight loss according to the content?

  • Adrenal insufficiency (correct)
  • Hypothyroidism
  • Cushing's syndrome
  • Type 2 diabetes

Which infectious disease is specifically mentioned as a cause of unintentional weight loss?

<p>HIV (B)</p> Signup and view all the answers

Which lifestyle factor is implicated in causing unintentional weight loss?

<p>Vigorous exercise (C)</p> Signup and view all the answers

What is a common endocrine cause of unintentional weight loss?

<p>Hyperthyroidism (D)</p> Signup and view all the answers

Which hormone is primarily synthesized by the pituitary gland?

<p>Growth hormone (A)</p> Signup and view all the answers

When examining a patient with abdominal pain and weight loss, which symptom might indicate an endocrine disorder?

<p>Frequent palpitations (D)</p> Signup and view all the answers

Which symptom is NOT typical in cases of unintentional weight gain due to endocrine causes?

<p>Rapid heart rate (D)</p> Signup and view all the answers

What aspect of obesity does pharmacotherapy primarily address?

<p>Hormonal imbalances (C)</p> Signup and view all the answers

In the context of endocrine disorders, what does a palpable liver indicate?

<p>Potential hormonal imbalance (D)</p> Signup and view all the answers

Which of the following is a characteristic finding in a patient with hyperthyroidism?

<p>Increased heart rate (C)</p> Signup and view all the answers

What is the primary focus in managing unintentional weight loss caused by endocrine disorders?

<p>Addressing the underlying endocrine issue (D)</p> Signup and view all the answers

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Study Notes

Patient History

  • Female, 62 years old.
  • Presented to the emergency department with severe abdominal pain and unintentional weight loss of 9kg in 3 months.
  • Reports experiencing anxiety, frequent palpitations, difficulty concentrating, dyspnoea and diarrhoea.
  • Prior abdominal CT scan, performed several weeks ago, displayed no abnormalities.

Patient Examination

  • Anxious and agitated
  • Vitals:
    • Temperature 36.9 °C
    • Blood pressure 160/90 mm Hg
    • Pulse rate 130/min and regular
    • Respiratory rate 22/min
  • Skin warm and moist.
  • Cardiac examination:
    • Grade 2/6 systolic murmur.
  • Lung examination:
    • Crackles heard.
  • Abdominal examination:
    • Palpable liver 2 cm below the right costal margin.

Differential Diagnosis

  • Malignancy
  • Gastrointestinal disorders
  • Psychiatric conditions
  • Endocrine diseases
  • Infectious diseases
  • Neurological diseases
  • Advanced chronic disease
  • Chronic vigorous exercise
  • Medications/substances

Causes of Unintentional Weight Loss

  • Gastrointestinal disorders:
    • Peptic ulcer disease
    • Celiac disease
    • Inflammatory bowel disease (IBD)
  • Psychiatric conditions:
    • Depression
    • Eating disorders
  • Endocrine diseases:
    • Hyperthyroidism
    • Adrenal insufficiency
    • Diabetes (uncontrolled)
  • Infectious diseases:
    • HIV
    • Tuberculosis (TB)
    • Chronic helminthic infections
  • Neurological diseases:
    • Stroke
    • Parkinson’s disease
  • Advanced chronic disease:
    • End-stage heart failure
    • Renal failure
  • Chronic vigorous exercise:
    • Distance running
    • Ballet dancing
    • Gymnastics
  • Medications/substances:
    • Alcohol
    • Cocaine
    • Amphetamines
    • Prescribed drugs for diabetes, hypothyroidism.

Investigations

  • Bedside:
    • Electrocardiogram (ECG) shows sinus rhythm at 144 beats per minute (bpm).
    • Blood sugar (BM) 5.9.
  • Blood tests:
    • Thyroid-stimulating hormone (TSH)
    • (Normal Range)

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